Depression - Let’s Talk About It!
Dealing with Depression and Anemia in Pakistan
By Dr. Asma Badar, National Campaign Manager for White Ribbon Alliance Pakistan
Seema felt so depressed and drained, she was not able to enjoy her married life. Daily life and chores were hard to cope with and negative thoughts surrounded her like stubborn, overgrown ivy. She was hesitant to talk to her mother-in-law and husband about her mental state. Within days of it descending on her, she realized that the depression was just not going away. She decided that it was the time to go back to her mother’s place and catch up with friends and family. Seema’s mother had mixed feelings upon seeing her again after months away, and realized right away that Seema was not doing well. After, when Seema’s mother-in-law called to complain about Seema’s lazy attitude, Seema’s mother forced her to see the nearby doctor, where she got routine blood and urine samples done.
She went to see the doctor for the second time with the lab results in her hands. “Wonderful, you have been surviving with all this,” the doctor said, staring at her blood test like she couldn’t believe her to still be alive, “A hemoglobin level of 6mg/dl.”
“That is miserably low,” the doctor explained, “You’re extremely anemic and basically no oxygen is getting to your major organs, including brain. Low mood and depression is one of the symptoms related to long-standing anemia. You need to take iron supplements daily for a few months to fix this.”
“I am so thankful that my doctor thought to check my blood!”
Depression and Anemia
Anemia also presents in the form of depression symptoms that are largely neglected and rarely understood and treated. Anemia is a condition in which blood has a lower than normal number of red blood cells, sometimes caused by lack of iron, which plays an important role in carrying oxygen from the lungs to the rest of the body.
Here in Pakistan, we are living in a country where Seema and more than 50% of the women of her age group are suffering from Anemia. And, the situation has not gotten any better for the last 15 years. Instead, rates have risen to a point where we now stand at 180th out of 185 countries with the highest prevalence of Anemia. Keeping at this pace, Global Nutrition Report 2016 predicts that it will take another 100 years for Pakistan to reach the United Nations’ Sustainable Development Goals 2 (Zero Hunger) and 3 (Good Health and Well-Being) of a fifty percent reduction in Anemia cases by 2025.
Pakistan will bear the consequences of high Anemia rates for generations to come in terms of poor pregnancy outcomes for both mothers and newborns, increased risk of infant mortality, premature delivery, low birth weight babies, and reduced cognitive abilities in children, which can lead to poor school performance in the later years.
In Pakistan, there are issues with availability and coverage of IFA tablets (iron and folic acid supplements) provided to pregnant and lactating mothers at the community and facility levels. The Pakistan Demographic and Health Survey (PDHS) 2012–13 disclosed that 50% of the women who are given IFA during pregnancy actually do not take it for the full 6 months. And, there are concerns around poor compliance, inadequate counselling and follow up by the healthcare providers, poor dietary diversity, and eating habits. There is a lack of focus on adolescent girls — who are future mothers all facing a similar situation to what Seema had to live through — and repeated pregnancies and inadequate spacing is largely contributing to this long-standing health issue for the women in the country.
Let’s Talk
It is time that Pakistan — and the entire world — considered the serious impact Anemia has on mental health. “Depression” is this year’s theme for World Health Day (April 7, 2017), and as more people understand the debilitating cost of depression and look toward solutions, we hope that the side effects of Anemia are considered. Together, we can begin to take serious steps toward preventing more women and children from being harmed by Anemia’s devastating, long-lasting consequences.
To learn more about WRA Pakistan, follow us on Twitter and participate in our online #EndingMaternalAnemia campaign.
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